Association of Systemic Inflammation with Depressive Symptoms in Individuals with COPD

Abstract

Rationale Depression is a prevalent comorbidity of chronic obstructive pulmonary disease (COPD) that, along with COPD, has been associated with inflammation. An association between inflammation and depression in COPD has not been validated in a large COPD cohort. Methods Individuals from the University of Pittsburgh SCCOR cohort and the COPDGene cohort with tobacco use history and airway obstruction (FEV 1 /FVC <0.7) were evaluated using the Beck Depression Inventory II (BDI-II) and the Hospital Anxiety and Depression Scale (HADS), respectively. Participants completed symptom-related questionnaires and plasma IL-6 measurements. T -test, Fisher’s Exact tests and logistic regression were used for statistical analysis. Results The SCCOR cohort included 220 obstructed participants: 44% female and 21.4% with elevated depressive symptoms. GOLD staging distribution was predominantly stage I and II. The COPDGene cohort included 745 obstructed participants: 44% female and 13.0% with elevated depressive symptoms. GOLD distribution was predominantly stage II and III. In the SCCOR cohort, correlation between IL-6 and depressive symptoms trended toward significance (p= 0.08). Multivariable modeling adjusted for FEV 1 , age, gender and medical comorbidities showed a significant association (OR = 1.70, 95% CI = 1.08–2.69). IL-6 was significantly associated with elevated depressive symptoms in COPDGene in both univariate (p=0.001) and multivariable modeling (OR = 1.52, 95% CI =1.13–2.04). Conclusion Elevated plasma IL-6 levels are associated with depressive symptoms in individuals with COPD independent of airflow limitation and comorbid risk factors for depression. Our results suggest that systemic inflammation may play a significant and possibly bidirectional role in depression associated with COPD.

Nomogram as a predictive model for depression risk in chronic obstructive pulmonary disease

“…The apparent reduction in depression and anxiety as people age may be due to a series of factors, Firstly older Participants may have di culties and Secondly they will considered that physical disabilities and functional limitations are uncommon after retirement. But younger patients may nd it di cult to accept lifestyle changes, leading to a higher risk of depression [13] .Previous studies have demonstrated elevated systemic in ammatory markers in COPD patients, including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) [14]- [15] ,Recent literature has shown that adults with major depression are associated with elevated IL-1ß, IL-6, and CRP. A recent study of a sample of older adults showed that elevated levels of the in ammatory biomarker C-reactive protein are partly responsible for depressive symptoms and COPD [16] .Higher CRP were associated with an increased risk of depression in patients with COPD [17] .…”

Omega-3 Polyunsaturated Fatty Acids in Managing Comorbid Mood Disorders in Chronic Obstructive Pulmonary Disease (COPD): A Review

“…Moreover, a study that analyzed induced sputum samples from COPD patients (n = 26) and healthy controls (n = 21) reported significantly elevated levels of IL-6, IL-8, IL-13, and monocyte chemoattractant protein (MCP)-1 in the airway of COPD patients compared to healthy controls [ 69 ]. Elevated IL-6 levels in plasma are linked to depressive symptoms in COPD, independent of airflow limitation and comorbid risk factors for depression [ 70 ]. In addition, soluble TNF receptor-1 (sTNFR-1) was significantly associated with depression in COPD [ 65 ], while depression ratings have been positively associated with plasma TNF-α levels in COPD [ 71 ].…”

Psycho-cognitive assessment and quality of life in older adults with chronic obstructive pulmonary disease-carrying the rs4713916 gene polymorphism (G/A) of gene FKBP5 and response to pulmonary rehabilitation: a proof of concept study

“…Patients with COPD often show psychiatric comorbidities, specifically: generalized anxiety, panic disorder, and depression (Su et al , 2017; Montserrat-Capdevila et al , 2018; Miravitlles et al , 2018; Puteikis et al , 2021; Strollo et al , 2021). These conditions are associated with poorer quality of life (QoL) (Spruit and Wouters, 2019), physical impairments, lower compliance to treatment plans, more severe exacerbation rates with more frequent emergency admissions and, ultimately, higher 30-day mortality compared to their counterparts without anxiety or depression (Pollok et al , 2019).…”